Provider Demographics
NPI:1265446132
Name:INTERNAL MEDICINE AND PEDIATRICS ASSOCIATES, PA
Entity Type:Organization
Organization Name:INTERNAL MEDICINE AND PEDIATRICS ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:WOMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-380-7531
Mailing Address - Street 1:224 HIGH HOUSE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-4278
Mailing Address - Country:US
Mailing Address - Phone:919-380-7531
Mailing Address - Fax:
Practice Address - Street 1:224 HIGH HOUSE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-4278
Practice Address - Country:US
Practice Address - Phone:919-380-7531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8988838Medicaid
NC0156KOtherBCBS
H13024Medicare UPIN
NC2001478Medicare ID - Type Unspecified
E01408Medicare UPIN